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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/ PLUMBING I SIGN I SPRINKLER i DEMOLITION <br /> #11111j-:"4— CITY OF EVERETT PERMIT SERVICES <br /> ' 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 [(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or.:Black;.Ink.Only;Ptoase):::.<:..:..: .. . . PROJECT SITE INFORMATION :. .......:.: . ..::....... <br /> PROJECT SITE ADDRESS:1405 OAKES AVE PROPERTY TAX#:00450628900200 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER NAME: DAVE BREWER TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 1405 OAKES AVE <br /> cm- EVERETT STATE WA zip 98201 <br /> OWNER PHONE: 206-390-4810 OWNER EMAIL DAVIBREW@COMCAST.NET <br /> CONTRACTOR NAME:GS HEATING <br /> CONTRACTOR ADDRESS: sTREEr3409 EVERETT AVE <br /> cm, EVERETT STATE WA Zip 98201 <br /> CONTRACTOR PHONE:425-252-4402 CONTRACTOR EMAIL:INSTALL@GSHEATING.COM <br /> CONTRACTOR LICENSE#(REQUIRED):GSH EAHC821 QR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 60058 <br /> — <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-252-4402 <br /> ALISHA CLOGSTON CONTACT EMAIL:ALISHA@GSHEATING.COM <br /> BUILDING INFORMATION . ... ... <br /> Existing Use of Building:RESIDENTAIL Contract Price of Work:$ (.04141.04Y <br /> Proposed Use of Building:RESIDENTAIL _Heat Source: ❑Gas ©Electric ❑Other <br /> BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑✓Remodel ❑Repair CT.!. ❑Sign ❑Sprinkler ODemolition OChange of Use <br /> DESCRIPTION OF WORK: GAS FURNACE REPLACEMENT <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> :::MECHANICAL:PERMIT:'APPLICATION • .; S.....:.• .:PLUMBING•PERMIT:APPLICATION ........ <br /> Fixture Fpeua Fixture Fixture <br /> Count List of Fixtures count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Ty e II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove interceptor-Sand/Oil Water Service(behind meter) <br /> 1 Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER?I SU PPRESSiON SYSTEM:: .. ..• Sewage Ejector or Sump Pump Other. <br /> Water Suppression System r No.of Heads <br /> Chemical Suppression System I No.of Heads <br /> ACKNOWLEDGEMENT I h,i a reviewed this application and confirm the Information contained herein is true and correct:Work done pursuant to this permit must compy with <br /> current federal,state,and Io.t law,The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before beins horned under any circumstance.I am the owner,orI am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the S i <br /> e •ntractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERM T# <br /> Owner/V ttP 0A Signature ate Revised 1 10/2018 <br />